Organization
NIEMANN FOODS INC
Active
Other names
COUNTY MARKET PHARMACY 227
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER NIEMANN (CFO)
(217) 221-5612
Entity
Organization
Contact information
Practice address
2777 S 6TH ST, SPRINGFIELD, IL 62703-4071
(217) 744-2296
(217) 744-9826
Mailing address
PO BOX C847, QUINCY, IL 62306-0847
(217) 221-5649
(217) 221-5915
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
054016034
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1479989
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
370475175004
—
IL
Enumeration date
08/31/2006
Last updated
09/27/2021
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